探讨曲面断层片测量下颌不对称畸形的可行性  

Validity of panoramic radiographs for measurements of mandibular asymmetry

作　　者：黄颖荷[1] 张春元[2] 钟小龙[2] 彭伟[2] 姜瑞[2] 

机构地区：[1]台山市人民医院·广东医学院附属台山医院口腔科,529200 [2]中山大学附属第一医院口腔科

出　　处：《中华医学美学美容杂志》2014年第5期355-360,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：广东省科技计划项目（编号：2011B080701086,2011B080701010）;广东省医学科研项目（编号：A2011689）

摘　　要：目的 探讨曲面断层测量法在分析下颌不对称畸形中的可行性.方法 选取25例主诉和外观皆无颜面部不对称的患者的曲面断层片（Pa）为对称组,16例颜面部不对称畸形患者的Pa和X线头颅后前位片（PAC）为不对称组.在两组的Pa影像上定位标志点,画出参考线和参考平面,确定相关测量项目.观察各定点位置的可重复性.比较对称组和不对称组的Pa左右两侧测量项目的差异,和两侧相应测量值的非对称率.对不对称组的Pa和PAC的相关测量项目的测量值进行相关性检验.结果 用参考线和参考平面辅助定位标志点的离散度＜无辅助定位者,颏下点（Me）的离散度＞颏孔点（MF）.第1作者前后两次定点的可重复性与另5位测量者相似.对称组Pa大部分测量项目和不对称组Pa所有测量项目两侧测量值的差异皆有统计学意义（P＜0.05）.代表垂直向测量值的髁突点与下颌角点的距离（CP-GoP）,两组平均相差4.73 mm（P＜0.01）;代表水平向测量值的下颌角点与颏孔点的距离（GoP-MF）,两组平均相差5.77 mm（P＜0.01）.Pa与PAC水平向测量结果有较强的相关性（相关系数：0.78～0.85,P＜0.01）,垂直向测量结果相关性较差（相关系数：0.64,P＜0.01）.结论 参考线和参考平面辅助定位可提高Pa定点的可重复性,使定点更加明确;Pa影像颏孔点可用于曲面断层测量;曲面断层测量法可作为评价下颌是否不对称的方法.Objective To evaluate the reliability of the panoramic radiographs for diagnosing mandibular asymmetry.Methods A total of 25 cases with no asymmetry in chief complaint or in appearance were selected for symmetry group.Pa and PAC from 16 cases of facial asymmetry were selected for asymmetric group.Marker points were fixed,a reference line and the reference plane drawn,and then relevant measurement items determined.The repeatability of the fixed position was observed.The difference of all measurement items between the left and right on Pa in symmetry group and asymmetric group were compared respectively and the asymmetric rate of corresponding measuredvalues on two sides between two groups were observed too.Correlation test was used to evaluate the measured-values on Pa and PAC in asymmetric group.Results Dispersion became smaller with the help of reference line and reference plane.And the dispersion was larger when Me was used as a marker other than MF.Most measured-values in symmetry group on Pa and all measured-values in asymmetric group on Pa showed statistically significant difference （P〈 0.05）.The mean difference of CP-GoP distance representing the vertical measured-value was 4.73 mm （P〈0.01）; and the mean difference of GoP-MF distance representing the horizontal measured-value was 5.77 mm （P〈0.01）.The horizontal measurements on PA and PAC showed closer correlation （r=0.78～0.85,P〈0.01） while the vertical was poorer （r=0.64,P〈0.01）.Conclusions This study suggests that marking assisted with reference line and reference plane could get a more repeatable fixed-point on Pa.MF point could be used as a fixed-point for measuring mandibular asymmetry on Pa and the Pa measurement can be used to evaluate mandibular asymmetry.

关 键 词：颌面畸形 放射摄影术 体层摄影术 曲面断层片 PANORAMIC (Pa) 

分 类 号：R782.2[医药卫生—口腔医学]